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Fingers: Trigger-Finger Syndrome

The morning after a day of hard gym bouldering, I noticed a popping or mild locking in my left middle finger when opening and closing it. The feeling soon went away, but came back worse every consecutive morning. I took two weeks off from climbing and my finger was feeling good, so I climbed very moderately two days ago, but this morning the popping returned. Any suggestions?

Jay | rockandice.com Forum

This aptly named condition, Trigger Finger, is a cyst that forms in one of the flexor tendons near the aperture of the flexor sheath. The cyst gets caught inside the sheath, hence the locking sensation, which suddenly releases when you forcibly extend the finger. Normal function prevails until you flex it such that the cyst pops inside the aperture and becomes stuck again.

Akin to having dust in your gun, it will work most of the time but don't count on it. Typically it is worse in the mornings when fluid has had time to accumulate.

Not being able to reproduce the locking sensation after flexing your finger in the morning is fairly normal. Once the cyst has passed in and out of the aperture of the flexor sheath several times fluid within the cyst is squeezed out, or at least the dimensions alter to allow silky smooth sliding action.

You may notice a small lump in the base of your finger if you palpate at the same time as flexing and extending your finger. It will feel like a 1- to 2-milimeter pea.

I have had little luck treating Trigger Finger. There is a reasonable argument that some manual therapy to try and offload stress on the cyst might help. Its effectiveness, though, seems only slightly less random than Reiki.

Certainly the acupuncturists I have spoken with indicate they have had success, so that may be worth a try.

Anti-inflammatory medication does very little. The same goes for taping/immobilization. In fact, the latter will often attract a few additional problems and is generally just a pain in the proverbial.

Your climbing should be unaffected as long as the locking sensation is just in the morning. You are certainly not doing any significant damage by continuing to climb. It will just be annoying.

Sorry I can't give you a fix-it recipe. Western medicine has very little to offer you. Usually the problem goes away with time. If it gets really troubling, surgery may be an option, though it is not one I would take lightly.